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Two well-produced evidence-based guidelines covering the diagnosis and management of children with asthma have both been updated in 2007. In the USA, the National Institute for Health (NIH) has published a major update to their 2002 guideline, based on a literature search up to mid-March 2006.1 In the UK, the guideline produced jointly by the British Thoracic Society (BTS) and the Scottish Intercollegiate Guideline Network (SIGN)2 is a so-called “living guideline”, notable in that at the outset it had been decided to maintain the guideline up to date using regular reviews. It has been updated three times since it was first published in February 2003, most recently in 2007 based on a literature search up to the end of December 2005. The changes are colour coded in the text. A major update is planned for next year.

This guideline review focuses on comparing the changes in recommended management in the NIH and the BTS/SIGN guidelines: where one guideline has made a change the corresponding recommendation in the other …

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↵* Dose given via a hydrofluoroalkane (HFA) MDI. This is approximately equivalent to twice the dose via a chlorofluorocarbon (CFC) inhaler; †dose given via a CFC MDI, approximately equivalent to half the dose of an HFA MDI.

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2008 BMJ Publishing Group & Royal College of Paediatrics and Child Health